The National Institute on Drug Abuse (NIDA) estimates that 40 to 60 percent of people who were once addicted to drugs or alcohol will eventually relapse.
Relapse into drug or alcohol addiction has recognizable stages, and each stage has risks that could lead to relapse.
In treatment, patients learn how to recognize the early stages, in which the chances of preventing relapse are greatest.
The main relapse prevention tools are cognitive therapy and mind-body relaxation. They counter negative thinking and help the person develop healthy coping skills.
Most relapse prevention relates to a few basic rules. Educating patients about these rules can help them focus on what they need to do to form effective relapse prevention strategies.
Recognizable Stages of Relapse
Relapse is a gradual process and begins weeks before a person in recovery begins drug or alcohol use. Substance abuse treatment programs teach patients how to recognize the warning signs so they can prevent relapse early in the process.
Health professionals offer different numbers of stages. For simplicity, let’s go with a three-stage model.
Emotional Relapse
Patients in recovery are not thinking about using again after treatment, but their emotions and unhealthy behaviors set them up for relapse. Denial is a significant factor in this stage.
Signs of emotional relapse include stifling emotions, being alone, avoiding meetings, not sharing during meetings, emphasizing other people’s problems, poor nutrition, and lack of sleep.
Mental Relapse
During mental relapse, the person in recovery is at war with themselves within their mind. As this stage proceeds, cognitive resistance to drug abuse lessens and their need to “escape” through drug use increases.
Signs of mental relapse include a craving for substances, pleasant memories of past use, minimizing the risks or glamourizing past use, making deals, lying, thinking they can control use better this time, looking for opportunities, and planning how to do it.
Physical Relapse to Drug and Alcohol Addiction
Physical relapse is when the person takes the substance.
Physical relapse is often an act of opportunity. The person thinks they can get away with a drink or a pill and no one will know about it. These are the type of situations those in the recovery process need to mentally rehearse as part of their relapse prevention plan so they can recognize them and avoid relapse.
Learning the necessary coping skills and having a relapse prevention plan is essential to staying sober.
Relapse Prevention Tools
As noted above, the primary relapse prevention tools are cognitive behavior therapy and mind-body relaxation. Participation in a self-help group like Alcoholics Anonymous can also be helpful in relapse prevention.
Cognitive Behavior Therapy
Cognitive behavior therapy, often taught during addiction treatment, is a proven tool for offsetting negative thinking and developing healthy coping skills to avoid future relapses.
Addictive thinking is all-or-nothing thinking. It negates positive thoughts, makes everything a catastrophe, and promotes self-doubt. This leads to anxiety, resentment, stress, and depression.
Cognitive behavioral therapies break down addictive thinking habits and retrain thought patterns to produce healthier ways of reasoning.
Tenets of Cognitive Behavior Therapy
The Beck Institute of Cognitive Behavior Therapy states 14 tenets of good CBT on its website.
- Treatment plans are based on an ever-evolving cognitive conceptualization.
- CBT requires a sound therapeutic relationship.
- It continually monitors client progress.
- It is culturally adapted and tailors treatment to the individual.
- It emphasizes the positive.
- It stresses collaboration and active participation.
- It is aspirational, values-based, and purposeful.
- It initially emphasizes the present.
- It is educative.
- It is time-sensitive.
- Its sessions are structured.
- It used guided discovery and teaches clients to respond to their dysfunctional cognitions.
- It includes action plans.
- It uses a variety of techniques to change thinking, mood, and behavior. (Beck Institute, 2022).
Mind and Body Relaxation
Mind-and body relaxation is proven to help reduce drug and alcohol abuse and is effective in long-term efforts to prevent relapse. Also taught during addiction treatment, it counteracts stress and tension, which are basic triggers of addiction relapse.
Mind and body relaxation helps people avoid dwelling on the past or worrying about the future. It is a way of being kind to oneself. Self-care during this practice can be a useful part of the rest of the person’s life.
Mind and Body Relaxation Differences
It is important to note the similarities and differences between meditation and body relaxation practices, given their widespread use overlaps each other.
Meditation (mindfulness) is a 2500-year-old practice grounded in Asian philosophy and ethics, particularly Buddhism.
The body relaxation response was first identified in the 1970s by Dr. Herbert Benson of the Harvard Medical school and refers to a physiological state of parasympathetic dominance.
Mind and Body Relaxation Similarities
- Both can elicit a relaxation response that offsets stress
- Both are multi-modal and incorporate bits of each other
- There is evidence that they impact each other
- They share common elements and may be used together
The 12 Steps and Relapse Prevention
Participation in 12-step program support groups, such as Alcoholics Anonymous or Narcotics Anonymous, is also helpful in relapse prevention.
The need to attend meetings regularly and interact with others in a recovery circle trying to live a sober life helps the person in recovery identify and respond to the common triggers of relapse.
Other recovering individuals in a self-help group and sponsors can be completely honest with each other and provide a support group for celebrating developmental milestones in their personal growth.
Mental Health Issues and Relapse
Individuals diagnosed with both substance abuse and mental health issues have high rates of relapse.
They are dealing with two or more health conditions and have more impactful symptoms. This impairs their natural ability to cope with the stress of their condition and increases the risk of relapse.
This is another reason a good relapse prevention plan is important.
Important Questions about Mental Illness
The magnitude of substance abuse among mentally ill individuals, and their associated problems, brings up several important questions.
- Can patients trying to improve mental health maintain abstinence following treatment?
- What is the relapse rate for individuals with mental health disorders?
- What factors pertaining to persons with mental health disorders foretell relapse to substance use?
Substance Abuse and Brain Chemistry
Some people relapse because of the damage drug and alcohol addiction caused to their brains.
Behavioral studies show that drug-related stimuli, drugs themselves and stressors are powerful triggers for substance use disorder relapse.
Scientific studies have identified lasting brain chemistry changes arising from exposure to drugs.
Chronic drug use increases the sensitivity of some brain systems to the drugs’ effects, especially when combined with stressful events. This, in turn, makes the user more susceptible to the common triggers of relapse.
Can Brain Chemistry Heal?
To some degree, the brain can recover after substance abuse, but only after a period of abstinence.
This is why it is important to have a relapse prevention plan and follow it.
Relapse Does Not Mean Treatment Failed
For some people relapse can be part of the recovery process, according to the National Institute on Drug Abuse.
Relapse rates for drug use are similar to rates for other chronic medical illnesses. If people stop following their medical treatment plan, they are likely to relapse, whatever the illness.
Time to Start Over
When a person recovering from drug or alcohol abuse relapses, that person needs to speak with their therapist or doctor to resume treatment, modify it, or try another treatment.
They need to find their successful recovery process.
A good relapse prevention plan should include practiced methods for coping with stress and negative events which may trigger a relapse.
Addiction Treatment at La Hacienda
La Hacienda Treatment Center has been successfully helping people with drug or alcohol abuse conditions for 50 years.
An onsite medical team of health professionals certified in addiction medicine meets with patients daily from their arrival to completion of treatment. There are also psychiatrists to address mental health concerns.
A thorough medical assessment is performed upon admission to outline treatment options based upon the patient’s individual needs.
Medically supervised detoxification to help manage withdrawal symptoms is available if needed before a patient can start treatment.
Families Learn to Help
Family members are invited to participate in a four-day program so they can learn about the disease and how they can help their loved one avoid relapse. This family therapy is provided at no additional cost.
Counselors help each patient prepare a continuing care plan for post-treatment recovery from drugs or alcohol. This includes a list of counselors and support groups in their home area.
If you or someone you know needs help with substance addiction or substance abuse problems, phone (800) 749-6160 and talk with one of our helpful onsite admission specialists today.
Treating Relapse
In early recovery, patients learn how to recognize the initial stages of potential relapse, when their relapse prevention plans may have the best chance of success. The main substance dependence relapse prevention tools are cognitive therapy and mind-body relaxation. They change negative thinking and develop healthy coping skills.
Signs of Relapse
A change in attitude, increased stress, more denial, a recurrence of withdrawal symptoms, poor self-care, behavioral changes, less socializing, abandoning routines such as a healthy diet, engaging in high-risk situations, irrational choice-making, and limiting one’s choices are some warning signs of future relapse into drug use.
Trading Addictions
People in recovery from a substance use disorder following addiction treatment sometimes trade one drug use or addictive behavior for another. Becoming compulsively involved in an activity such as work or exercise can be a positive, but if the person is trading for a new addiction for the old one, it may interfere with their drug abuse or alcohol abuse recovery.
Relapse Definition
Relapse is a return to using drugs or alcohol after an attempt to stop. Relapse rates for substance use are similar to those for other chronic medical conditions. People who abandon their approved drug rehab continuing care treatment, including relapse prevention plans, are more likely to relapse into old habits of substance dependence than those who stick with their plan.
Beck Institute for Cognitive Behavioral Therapy. (2022). Retrieved from https://beckinstitute.org/about/intro-to-cbt/
